Macular Degeneration Treatment Sydney
Macular degeneration is one of the most common causes of central vision loss in older adults and remains one of the most important retinal conditions encountered in modern ophthalmology. It affects the macula, the specialised central part of the retina responsible for detailed vision used for reading, driving, facial recognition and many everyday visual tasks.
At Eye and Retina Specialists, we provide comprehensive assessment and management of both dry and wet macular degeneration, including OCT retinal imaging, long-term retinal monitoring and intravitreal eye injectionAt Eye and Retina Specialists we provide specialised treatment for macular degeneration with a strong focus on modern intravitreal injection therapies (anti-VEGF and complement inhibitors)..
At Eye and Retina Specialists we provide specialised treatment for macular degeneration with a strong focus on providing patient understanding of their condition
A diagnosis of macular degeneration can be confronting. Many patients immediately worry about blindness, losing independence or requiring injections into the eye. These concerns are understandable.
Modern retinal treatments, however, have dramatically improved outcomes for many patients, particularly those with wet macular degeneration, where early diagnosis and treatment can often preserve useful central vision for years.
Macular degeneration management involves careful interpretation of retinal imaging, recognition of subtle disease activity, monitoring changes over time and individualising treatment according to how each eye responds to treatment. At our clinic, consultations focus on helping patients understand their retinal condition, OCT findings, and understanding the long-term management strategy.
Macular degeneration can affect reading, computer use, facial recognition and many everyday tasks requiring detailed central vision
On This Page
What is Macular Degeneration?
Symptoms of Macular Degeneration
Types of Macular Degeneration
Diagnosis of Macular Degeneration
Treatment for Wet Macular Degeneration
Treatment for Dry Macular Degeneration
Geographic Atrophy
Living with Macular Degeneration
Specialists in Macular Degeneration
Frequently Asked Questions
What is Macular Degeneration?
Macular degeneration, also known as age-related macular degeneration or AMD, is a retinal condition affecting the macula, the central part of the retina responsible for detailed vision. The macula allows us to read, recognise faces, see fine detail, use screens, drive and perform tasks that require precise central vision.
When the macula is affected, patients may notice blur, distortion, missing areas in the centre of vision or difficulty seeing detail, even if their peripheral vision remains relatively preserved.
The condition becomes more common with age and is influenced by a combination of genetic, lifestyle and vascular risk factors. Smoking is one of the most important modifiable risk factors. Family history is also relevant, although the severity and progression of AMD vary considerably between individuals.
Macular degeneration is thought to be due to a combination of genetic and environmental factors. Macular degeneration is the leading cause of blindness in Australians over 60 years old. The more serious form, wet macular degeneration, often requires treatment with eye injections. More recently, injections are available for advanced dry macular degeneration (atrophy).
Simulation of macular degeneration causing blurred central vision and distortion while peripheral vision usually remains relatively preserved
Symptoms of Macular Degeneration
Symptoms may include:
• Distorted or wavy vision
• Difficulty reading
• Blurred or dark central vision
• Words appearing distorted or letters missing while reading
Wet macular degeneration may cause sudden visual distortion or central blur and requires urgent assessment.
Simulation demonstrating the central distortion and patchy missing vision that may occur with macular degeneration while reading
Types of Macular Degeneration
There are two main types of age-related macular degeneration. The most important clinical distinction is between dry macular degeneration, which usually progresses more gradually, and wet macular degeneration, which can cause more rapid central vision loss if abnormal leaking blood vessels develop beneath the macula.
1. Dry Macular Degeneration
Dry macular degeneration, the more common form, is a gradual wear and tear ageing process of the retina. It can lead to worn down patches known as "geographic atrophy". Eye injections are now available to slow the process. Dry macular degeneration can transform to wet macular degeneration.
Dry macular degeneration is the more common form of AMD and is characterised by progressive degeneration of retinal tissue within the macula together with the development of drusen beneath the retina.
Drusen are yellow deposits that accumulate beneath the retinal pigment epithelium and are commonly seen during retinal examination and OCT imaging. Small drusen may occur as part of normal ageing, but larger drusen and associated retinal pigmentary changes increase the risk of progression to more advanced macular degeneration.
Many patients with early dry AMD initially have few symptoms and may notice only subtle reduction in contrast sensitivity, increasing difficulty reading in dim lighting or mild deterioration in central visual clarity despite updated glasses.
Dry macular degeneration is commonly associated with drusen and gradual degeneration within the central retina
Unlike wet macular degeneration, dry AMD usually progresses more gradually. However, advanced dry AMD can still significantly affect reading vision, facial recognition and detailed central visual function.
For many patients, management focuses on careful retinal monitoring, smoking cessation, cardiovascular risk reduction and nutritional strategies including AREDS2 supplementation in appropriate patients.
Even in patients with predominantly dry AMD, ongoing retinal monitoring remains important because some eyes may later convert to wet macular degeneration requiring urgent anti-VEGF treatment or progress to advanced atrophic macular degeneration.
2. Wet Macular Degeneration
Wet macular degeneration is the more aggressive and vision-threatening form of AMD. It occurs when abnormal blood vessels develop beneath the macula and begin leaking fluid, lipid or blood into the central retina.
Without treatment, this leakage can rapidly damage the photoreceptors responsible for detailed central vision.
Colour retinal photograph demonstrating neovascular (wet) age-related macular degeneration with subretinal haemorrhage
Some patients notice relatively sudden deterioration over days or weeks, while others initially develop more subtle distortion, blurred central vision or increasing difficulty reading.
Straight lines may appear bent or wavy. Words on a page may seem distorted or partially missing. Some patients notice that faces become harder to recognise or that one eye suddenly appears dimmer or blurrier than the other.
Because the better-seeing eye may compensate initially, significant retinal fluid can occasionally develop before patients fully appreciate the severity of the problem.
Wet macular degeneration is particularly important because timing matters. Earlier diagnosis and treatment are generally associated with better long-term visual outcomes. Once chronic scarring, fibrosis or irreversible photoreceptor damage develops beneath the macula, visual recovery becomes less predictable even when leakage is successfully controlled.
At Eye and Retina Specialists, assessment of wet AMD involves detailed retinal examination together with high-resolution OCT imaging to determine whether fluid, bleeding or neovascular membranes are present beneath the retina.
Diagnosis of Macular Degeneration
The diagnosis of macular degeneration involves retinal examination and retinal imaging to confirm the diagnosis and assess the type, severity and activity of disease.
At Eye and Retina Specialists, assessment commonly includes high-resolution OCT imaging, retinal photography and, in selected patients, fluorescein angiography and/or ICG angiography.
OCT imaging provides high-resolution cross-sectional visualisation of the retina. OCT can identify intraretinal fluid, subretinal fluid, pigment epithelial detachments, drusen, fibrosis and areas of retinal atrophy. OCT imaging assists not only with diagnosis, but also with guiding treatment decisions and ongoing management.
Fundus fluorescein angiography (FFA) involves injection of a fluorescent dye into a vein in the arm followed by rapid retinal photography as the dye circulates through the retinal blood vessels. This allows visualisation of vascular leakage, abnormal neovascular membranes and patterns of retinal vascular activity. With improvements in OCT imaging technology, FFA is now required less frequently than in the past.
In selected cases, indocyanine green angiography (ICG angiography) may also be beneficial. ICG uses a green dye and different imaging wavelength that allows better visualisation of deeper choroidal blood vessels beneath the retina. This can be particularly useful when assessing conditions such as idiopathic polypoidal choroidal vasculopathy (PCV), a subtype of wet macular degeneration more commonly seen in patients of Asian background that may behave differently to typical wet AMD.
Multimodal retinal imaging including OCT, fluorescein angiography, autofluorescence and retinal photography used in the diagnosis and management of macular degeneration
Treatment for Wet Macular Degeneration
Intravitreal injections are the primary treatment for wet macular degeneration and are used to control abnormal vascular leakage beneath the retina.
Current intravitreal medications target vascular leakage pathways involved in neovascular AMD, including VEGF-A and angiopoietin-2. These treatments aim to reduce retinal fluid, stabilise the macula and preserve central vision.
The medications are administered as intravitreal injections directly into the eye. Although the concept of an eye injection is understandably confronting for many patients initially, the procedure itself is quick and generally well tolerated. Before treatment, the eye is generously numbed with anaesthetic drops and cleaned carefully with antiseptic to reduce infection risk. There is normally little pain, with some patients describing a mild pressure sensation.
At Eye and Retina Specialists we offer dedicated expertise in intravitreal injection therapy for macular degeneration, with treatment tailored individually to each patient. Our clinic specialises in intravitreal injection therapy for the treatment of wet macular degenration, using medications including:
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Eylea 2mg or Afqlir (aflibercept)
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Eylea HD 8mg (aflibercept)
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Vabysmo (faricimab)
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Lucentis (ranibizumab)
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Syfovre (pegcetacoplan) - to reduce the rate of development of macular geographic atrophy when clinically appropriate
Intravitreal medications used in the treatment of wet macular degeneration and geographic atrophy
Treatment is tailored individually, with ongoing monitoring with OCT imaging. Wet macular degeneration requires ongoing intravitreal injections together with long-term OCT-guided retinal monitoring. The aim of treatment is to maintain retinal stability, minimise recurrent fluid and preserve useful functional central vision.
Some patients experience improvement in vision following treatment, particularly when therapy begins before significant scarring or chronic photoreceptor damage has developed. However, injections cannot reverse retinal injury that already existed before treatment commenced.
Treatment intervals are individualised according to OCT findings, disease activity and the long-term behaviour of the retina. Many patients are managed using a treat-and-extend approach, where injection intervals are gradually adjusted according to retinal stability. If retinal fluid recurs or disease activity increases again, treatment intervals may need to shorten.
At Eye and Retina Specialists, treatment decisions are guided by detailed retinal imaging, visual function, previous treatment response and the long-term pattern of disease activity.
Treatment for Dry Macular Degeneration
Although dry macular degeneration cannot currently be reversed, there are measures that may help reduce the risk of progression and preserve retinal health over time.
Smoking and Vascular Health
Smoking remains one of the strongest modifiable risk factors associated with progression of macular degeneration. Patients with macular degeneration should ideally avoid smoking completely, including passive cigarette smoke exposure where possible. Smoking is associated with oxidative stress and vascular compromise within the retina and increases the risk of progression to advanced macular degeneration.
Attention to cardiovascular health is also important. Blood pressure control, regular exercise and management of vascular risk factors may all contribute to long-term retinal health given the close relationship between retinal and systemic vascular function.
Diet and Nutrition in Macular Degeneration
Dietary factors appear to influence progression risk in some patients with AMD. Patients are often encouraged to maintain a balanced diet rich in leafy green vegetables, coloured vegetables, fruit and oily fish. Dietary patterns resembling a Mediterranean diet have been associated in some studies with lower rates of progression of macular degeneration.
Mediterranean-style diet rich in leafy green vegetables, oily fish, nuts and antioxidants associated with retinal and cardiovascular health
In patients with intermediate macular degeneration, or patients with wet macular degeneration in one eye and at-risk changes in the fellow eye, AREDS2-based supplementation may reduce the risk of progression to advanced AMD.
AREDS refers to the Age-Related Eye Disease Studies, large clinical trials conducted by the United States National Eye Institute investigating whether specific nutritional formulations could reduce progression of macular degeneration in higher-risk patients. The AREDS2 formulation contains a combination of antioxidants, zinc, copper, lutein and zeaxanthin.
The evidence for these supplements is that they may reduce the risk of progression to more advanced forms of macular degeneration in appropriately selected patients.
Commonly used Australian formulations include Macutec Once Daily and Blackmores Macu-Vision Plus. Macutec Once Daily more closely reflects the nutrient concentrations used in the AREDS2 study formulation, whereas Macu-Vision Plus contains only half the AREDS2 study dose for most major components including lutein, zeaxanthin, vitamin C, vitamin E and copper.
Patients should discuss supplementation with their ophthalmologist, particularly if they smoke, have previously smoked, take other supplements or have relevant medical conditions. Early detection of conversion to wet macular degeneration remains critically important because earlier treatment is generally associated with better long-term visual outcomes.
Healthy dietary patterns rich in leafy green vegetables, oily fish and fresh produce may help support retinal health in patients with macular degeneration
Monitoring Vision at Home
Patients with dry AMD are often advised to monitor vision in each eye separately because wet macular degeneration may occasionally develop gradually in one eye before becoming obvious binocularly.
Home monitoring using an Amsler grid may assist some patients in detecting new distortion or central visual change, although it does not replace retinal examination and OCT imaging.
Home monitoring with an Amsler grid may help detect new distortion or central visual change associated with macular degeneration
New distortion, blurred central vision or missing areas of vision should prompt urgent retinal assessment.
Long-Term Monitoring
Ongoing retinal monitoring remains important because dry AMD may slowly progress over time and can later convert to neovascular (wet) macular degeneration requiring intravitreal treatment.
Retinal examination, retinal imaging, fundus autofluorescence and OCT imaging help monitor drusen, retinal thinning, geographic atrophy and early signs of neovascular activity. Longitudinal imaging comparison is often particularly important because subtle structural change may occur gradually over time before major visual symptoms become obvious.
At Eye and Retina Specialists we often see patients with dry macular degeneration, or relatives of patients with macular degeneration, once a year for their annual checkup to monitor for signs of disease progression. These patients are aware to bring their appointment forward urgently if they notice any sudden new blurry or distorted vision during Amsler grid monitoring.
Geographic Atrophy in Macular Degeneration
Geographic atrophy (GA) is an advanced form of macular degeneration characterised by progressive degeneration and loss of retinal pigment epithelium, photoreceptors and underlying retinal support tissue. Geographic atrophy may occur in patients with dry or wet macular degeneration.
Patients with geographic atrophy may experience gradual enlargement of blurred or missing areas within the central vision. Reading difficulty, impaired face recognition and reduced contrast sensitivity commonly develop as areas of retinal atrophy enlarge over time. In some patients, vision remains relatively preserved for extended periods if the foveal centre is initially spared, whereas others develop substantial impairment once central involvement occurs.
Retinal imaging hasan important role in monitoring geographic atrophy progression. OCT imaging, fundus autofluorescence and retinal imagiung allow ongoing assessment of lesion size, location and progression over time.
Retinal imaging demonstrating geographic atrophyat the left eye macula with central retinal thinning and loss of retinal pigment epithelium
Management of Geographic Atrophy
Geographic atrophy (GA) is an advanced form of dry macular degeneration characterised by progressive loss of retinal tissue within the macula. Over time, these areas of atrophy enlarge, leading to irreversible blind spots affecting reading, facial recognition and central visual function.
Until recently, no treatment existed to slow progression of geographic atrophy. Newer therapies targeting the complement pathway have now emerged as treatment options.
Pegcetacoplan (SYFOVRE) is an intravitreal treatment approved in Australia to slow the progression of geographic atrophy secondary to age-related macular degeneration.
Treatment involves injections into the eye at regular intervals every2 months, aiming to slow enlargement of areas of retinal atrophy over time. Although treatment does not restore lost vision or reverse existing atrophy, slowing progression may help preserve useful functional vision for longer in selected patients. Complement inhibitor therapy may increase the risk of wet macular degeneration in some patients, so retinal monitoring remains important during treatment.
Not all patients with geographic atrophy are suitable candidates for treatment. Decisions regarding treatment depend on multiple factors including lesion location, visual function, rate of progression, fellow eye status, treatment burden and the potential balance between benefit and risk.
Some patients receiving treatment for wet macular degeneration may develop geographic atrophy and treatment for both conditions may be given concurrently at separate visits.
Living with Macular Degeneration
Macular degeneration affects far more than visual acuity alone. Reading, recognising faces, driving, using digital devices, shopping and functioning confidently in unfamiliar environments may all become increasingly difficult depending on the severity and location of retinal involvement.
Many patients are understandably anxious when first diagnosed, particularly if they have known relatives or friends who experienced severe visual loss from macular degeneration in previous generations. However, the outlook for many patients with wet macular degeneration has improved substantially over the past two decades. Easrly detection is critical.
Many of our patients at Eye and Retina Specialists continue to drive, participate in sporting activities, care for their grandchildren and continue with their lives while periodically having eye injections.
If treatment for wet macular degeneration is commenced as quickly as possible, many patients can continue with many of their previous activities such as playing golf
Practical support strategies can make a significant difference to day-to-day functioning. Brighter lighting, magnification, electronic reading aids, contrast-enhancing strategies and low-vision services may help maintain independence when central vision becomes impaired. Digital readers and other electonic devices are becoming increasingly used. Support organisations such as Vision Australia and the Macular Disease Foundation Australia may also provide useful educational resources and patient support services.
People with macular degeneration are required to notify their driver licensing authority when they are diagnosed with macular degeneration. This is to ensure that the person is legally deemed safe to drive and that appropriate monitoring is done to ensure ongoing safety for the individual and the broader community.
At Eye and Retina Specialists, consultations focus not only on retinal treatment itself, but also on helping patients understand their retinal imaging, realistic expectations and the long-term management strategy most appropriate for their individual needs.
Specialists in Macular Degeneration
Macular degeneration is one of the most common retinal conditions managed by our doctors at Eye and Retina Specialists. The clinic provides comprehensive management of all aspects of macular degeneration, including testing, diagnosis and treatment in a comfortable and convenient central Sydney location.
Patients are often referred to Eye and Retina Specialists by their optometrist, general practitioner or by word of mouth from family and friends. Some patients are referred by other ophthalmologists seeking subspecialty Medical Retina assessment and management.
Many patients choose to attend Eye and Retina Specialists having started treatment at a busy public hospital clinic. A referral from your optometrist or general practitioner is needed for patients to claim a Medicare rebate.
At Eye and Retina Specialists in Sydney, we welcome all patients to our clinic, and aim to provide excellence in communication and personalised care. Our specialists, led by Dr Neil Sharma, take the time to listen to your concerns, answer your questions, discuss treatment options and alternatives and explain your test results in a simple to understand manner.
Video clip of patient at Eye and Retina Specialists discussing her view of eye injections for wet macular degeneration
Rapid Macular Referral Service
Eye and Retina Specialists has established a Rapid Macula Referral Service for patients suspected of having newly diagnosed wet macular degeneration.
Early treatment is critical for the short- and long-term vision, aiming to stabilise the retina before permanent damage can occur.
For patients suspected of wet macular degeneration, we aim to provide an appointment to have the diagnosis confirmed, the severity of disease assessed and treatment commenced within 24-48 hours of you contacting us with your referral details.
Cost of Eye Injections
For people requiring regular eye injections, we recognise that short waiting times and being treated by your own eye specialist every visit are particularly important factors for ongoing care. At Eye and Retina Specialists, we believe in equitable eye health access and do our best to accommodate those with genuine need.
For an intravitreal eye injection, patients receive a standard Medicare rebate that in 2026 is $291 (85% of the schedule fee).
Original Medicare Safety Net (OMSN)
The 2026 threshold is $594 in a calendar year for everyone. Once this limit is reached, the Medicare rebate increases to $331 per injection (100% of the schedule fee). The safety net keeps a tally of your out-of-pocket and gap amounts for Medicare eligible services, including:
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general practitioner, optometrist and specialist consultations
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Out-of-hospital procedures (such as an eye injections, echocardiograms, stress tests, joint injections, skin cancer excisions performed in rooms)
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Diagnostic imaging (eg. ultrasounds, X-rays, CT, MRI scans)
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Pathology tests (eg blood tests, urine, swab tests)
Individuals are automatically enrolled by Services Australia into the Safety Net scheme. Couples and families need to register once so their combined out of pocket and gap payments are combined, meaning the threshold limits are reached more quickly. For further information and to download the form visit Services Australia.
Extended Medicare Safety Net (EMSN)
The 2026 threshold for the EMSN is $861 for pensioners and concession card holders, and $2699 for other individuals and families. Once your combined out-of-pocket costs pass your threshold, your Medicare rebate increases dramatically. For the rest of the calendar year, Medicare will refund you up to 80% of your out-of-pocket costs for out-of-hospital services
Reduced Rates
At Eye and Retina Specialists, we offer reduced pension rates for eligible patients. Where possible, our clinic supports patients with genuine need through our Retina Access Program (RAP) to reduce the out-of-pocket expense.
Clinic Injections
Except in rare circumstances, we routinely perform eye injections in the Procedure Room in our clinic using aseptic technique. This avoids unnecessary costs and delays associated with having an eye injection in a day surgery or private hospital facility. This approach is consistent with RANZCO Guidelines for Intravitreal Injections and the Choosing Wisely Australia campaign.
Areas We Cover
At Eye and Retina Specialists, we regularly treat patients from across Sydney, including Waterloo, Zetland, Moore Park, Alexandria, Beaconsfield, Redfern, Rosebery, Eveleigh, Kensington, Surry Hills, Darlington, Erskineville, Chippendale, Centennial Park, Mascot, Newtown, Haymarket, Paddington, Kingsford, Eastlakes, the Inner West and Eastern Suburbs. Patients travel from rural NSW and we also treat visitors from interstate and overseas.
Frequently Asked Questions
Q1. Can macular degeneration cause blindness?
Macular degeneration primarily affects central vision rather than peripheral vision, but advanced disease can still significantly affect independence and quality of life especially if both eyes are affected. .
Patients may struggle with reading, facial recognition, driving, digital device use and other detailed visual tasks. Wet macular degeneration can sometimes cause relatively rapid deterioration if significant leakage, bleeding or scarring develops beneath the macula.
Geographic atrophy may also progressively enlarge over time and interfere substantially with reading vision and central visual function.
Although intravitreal therapy cannot always restore vision already lost from chronic retinal damage, many patients now maintain useful functional central vision for years with appropriate monitoring and treatment.
Prompt assessment of new distortion, central blur or worsening vision remains particularly important.
Q2. Are eye injections painful?
Many patients are understandably anxious before their first intravitreal injection, but the procedure is usually much quicker and more tolerable than they had expected.
Anaesthetic drops are used to numb the eye before treatment. The eye is cleaned carefully with antiseptic to reduce infection risk, and the injection itself generally takes only a few moments.
Patients may notice pressure, awareness or mild discomfort.
Afterwards, the eye may feel gritty, watery or mildly irritated for several hours, often because of the antiseptic preparation. A red patch on the white of the eye may also occur temporarily.
Patients are provided instructions regarding symptoms requiring urgent review, including increasing pain, worsening vision, marked light sensitivity or increasing redness or discharge from the eye.
Q3. How often are injections given?
Injection frequency varies considerably depending on disease activity, OCT findings, medication response and the long-term behaviour of the retina.
When starting treatment, patient are given 3 injections, each one month apart, known as the "loading phase". If the wet macular degeneration improves, then a treat and extend approach is used where the interval between injections is increased by 1-2 weeks at a time.
If there are signs of reactivation of the wet macular degeneration, then the injection interval is shortened until the eye is stabilised. Thereafter the injection interval is again extended as the eye provided there are no further features of reactivation.
Q4. Why choose a retinal specialist clinic for macular degeneration?
Macular degeneration management depends heavily on detailed retinal imaging interpretation, recognition of subtle disease activity and long-term treatment planning.
A retina specialist routinely manages intravitreal injections, OCT imaging and complex retinal disease patterns. This becomes particularly important when deciding whether fluid is improving, recurring, stable or requiring adjustment of treatment intervals.
At Eye and Retina Specialists, macular degeneration care focuses on detailed retinal assessment, evidence-based treatment, longitudinal monitoring and practical communication tailored to the individual patient.